344 of the 487 Medicare-certified nursing homes in Missouri (71%) are chain-owned, and all are listed below. 11 of the 340 graded homes earn an A and 66 earn a D or F. They average 3.3 nursing hours per resident per day, 0.13 hours below the 3.43 for every home in Missouri. Lutheran Convalescent Home in Webster Groves grades highest at A (99 out of 100).
How chain-owned homes in Missouri compare
This group set against every nursing home in Missouri, from the current CMS release.
Nursing hours per resident per day
3.3
All homes in Missouri: 3.43
Worse than the local average
Nurse staff turnover
57.3%
All homes in Missouri: 56%
Worse than the local average
Average ElderGrade score
64.2/100
All homes in Missouri: 65.7/100
Worse than the local average
Grade spread
B
C
D
11 grade A, 92 grade B, 171 grade C, 66 grade D,
The best-graded chain-owned home in Missouri is
Lutheran Convalescent Home
in Webster Groves, MO, grade A, 99/100.
Grove At Kirkwood runs 117 certified beds as a nonprofit corporation, and its total nurse staffing sits at 3.86 hours per resident day, essentially matching the national average, not exceeding it. The problem isn't the raw staffing number; it's that weekends run about 10% below the home's own weekday level, and CMS gives just 1 of 5 stars on staffing overall, plus 2 of 5 on quality measures and 1 of 5 on health inspections. That inspection record includes 52 deficiencies, six at harm or jeopardy level, one abuse-related, and a single $172,400 fine. The last inspection was May 2024, so the picture isn't stale.
Nodaway Healthcare runs 60 beds in Maryville under for-profit LLC ownership, and the numbers behind its grade point to a building stretched thin on direct care. Nurse staffing sits at 3.09 hours per resident day, roughly a fifth below the national average, and it drops another 13% on weekends, when coverage is already thinnest. Staff turnover tells its own story: 73% of the workforce leaves each year, against a national rate near 46%. That churn shows up in the inspection record too, where 41 deficiencies are logged, including one tied to abuse, alongside a 2-out-of-5 health inspection rating and 1-out-of-5 marks for both quality measures and staffing. The most recent inspection was August 2025.
St Sophia runs 240 beds in Florissant under for-profit LLC ownership, and the staffing numbers are the first thing to look at: 2.86 nurse hours per resident per day against a national average of 3.86, with weekends about 16% thinner than weekdays. Turnover sits at 68.4%, roughly two-thirds of the nursing staff leaving in a year, well above the 45.8% norm, so the people caring for your relative are frequently new. The inspection record shows 87 deficiencies, including four at the harm level and three tied to abuse, with $69,203 in fines and a January 2025 inspection. Resident quality measures score well, but that's the one bright spot in an otherwise strained picture.
Country Villa runs 148 certified beds in Creve Coeur, and the staffing numbers are where the trouble shows. At 2.99 nurse hours per resident day, it sits roughly 23% under the national average of 3.86, and weekends drop about 18% below its own weekday coverage. Annual turnover hits 66% against a national 45.8%, so the people filling those shifts change often. The 21 deficiencies on record include one at the harm level, though none involve abuse. A recent June 2025 inspection and a four-star health inspection rating suggest the care environment itself has been watched closely. Ownership is for-profit corporate. If you're weighing this one, ask specifically how weekends and evenings are staffed.
Maple Grove Wellness & Rehabilitation runs 144 beds in Fenton under corporate ownership, and the staffing numbers are the first thing to notice: 2.61 nurse hours per resident per day, roughly a third below the national average, with a staffing star rating of 1 out of 5. Turnover sits at 70.7% against a national average near 46%, and weekend coverage drops about 9% below the home's own weekday level, so the gaps aren't evenly spread across the week. On the inspection side, 53 deficiencies are on the current record, including one at the harm level and one tied to abuse, and the most recent inspection was August 2025.
Rancho Rehab And Healthcare Center runs on about 3.30 nurse staffing hours per resident day, roughly 15 percent under the national average, and weekends drop another 15 percent below its own weekday levels. Staff turnover sits at 78.3 percent, well above the 45.8 percent national figure, so the people providing care keep changing. The current inspection record carries 52 deficiencies, three of them at the harm or jeopardy level and three abuse-related, with $28,060 in fines and a March 2025 inspection behind it. For-profit operation under an LLC, 120 certified beds. Families should ask directly who's on duty on weekends and how long the current director of nursing has been in place.
Aspire Senior Living New Florence runs on 2.84 nurse hours per resident day, about a quarter below the national average, and it thins out further on weekends, roughly 12% less coverage than its own weekdays. That staffing level earned a 1 out of 5 from CMS, and it shows in the numbers: 87.7% annual turnover, nearly double the national rate, meaning the people caring for your relative are largely new and likely to leave. The current record carries 35 deficiencies, three at harm or jeopardy level and one abuse-related, plus a $28,486 fine. Inspections were recent, in November 2025, with 2 out of 5 on both health inspections and quality measures.
Columbia Manor runs on 2.56 nurse hours per resident per day, roughly a third below the national average, and weekend coverage dips about 6% below its own weekday level. That thin staffing shows up in the numbers: 82% annual turnover, more than double the national rate, and a one-star CMS staffing rating. Inspections turned up 29 deficiencies, including one abuse-related citation, though none rose to actual harm or jeopardy, and the most recent visit was August 2025, so the record is current. The quality measure rating sits at 2 out of 5. For-profit, limited liability ownership. Ask about direct-care staffing on evenings and weekends before you decide.
Pacific Care Center runs lean on nursing staff, 2.40 hours per resident day against a national average of 3.86, and weekends drop roughly 14% below its own weekday level. Annual turnover sits at 66.7% versus 45.8% nationally, so the staff you meet on a Tuesday may not be there in six months. Its inspection record is current as of February 2026 and shows 35 deficiencies, none at the harm level but one tied to abuse. The federally reported quality measures rate 1 out of 5 stars, which is worth asking about directly. For-profit LLC ownership out of Franklin County.
Wellsville Health Care Center runs about 2.12 nurse hours per resident day, roughly 45% under the national average of 3.86, and weekends drop another 13% below its own weekday staffing. That thin coverage shows up in the numbers: a 1-out-of-5 staffing rating, 62.2% annual turnover against a national 45.8%, and 47 deficiencies on the current record, including six tied to abuse and one at the harm or jeopardy level. Inspectors last visited in May 2025 and the state has fined the for-profit LLC operator $20,642. Families weighing this home should ask directly how many nurses are on the floor on a Saturday night.
Grand River Health Care is a 60-bed for-profit home in Chillicothe, and the numbers are hard to dress up. Nurse staffing sits at 2.84 hours per resident per day against a national average of 3.86, roughly a quarter less hands-on time than the typical facility, and weekends run slightly thinner than weekdays on top of that. Staff turnover is 81.3%, nearly double the national rate, which means the people caring for residents are, more often than not, new.
The inspection record reflects that instability: 60 deficiencies on file, including 11 tied to abuse and four serious enough to put residents in harm's way, with $68,226 in fines. The last state visit was February 2025. One star each for health inspections and staffing tells you where the problems concentrate.
Parkway Health Care Center runs on 2.25 nurse hours per resident per day, roughly 42% under the national average, and weekends drop about 10% below its own weekday level. That thin coverage sits behind a one-star staffing rating. The inspection record is heavier: 98 deficiencies, including 2 at harm or jeopardy level and 8 tied to abuse, drawing $30,821 in fines. Staff turnover hits 67.4% against a national 45.8%, so the people providing care keep changing. The most recent inspection was October 23, 2024. Corporate-owned, 97 beds.
Bridgewood runs on 2.45 nursing hours per resident per day, roughly a third below the national average, and weekend coverage drops another 9% below its own weekday level, so the thinnest shifts are the ones families visit. Staff turnover sits at 58.3% against a national 45.8%, meaning the people providing that care are frequently new. The inspection record is what stands out most: 125 deficiencies, 26 of them at harm or jeopardy level, 36 tied to abuse, and $973,967 in fines across 13 penalties. CMS has placed it in the Special Focus Facility program, reserved for homes with a persistent pattern of poor care. The most recent inspection was April 28, 2025.
Cedar Pointe runs on 3.17 nurse hours per resident per day, roughly 18% under the national average of 3.86, and weekends drop about 15% below what the home staffs on weekdays. That thin coverage sits behind a 58.9% annual turnover rate, well above the 45.8% national figure, so the aides and nurses working the floor keep changing. The current record carries 39 deficiencies, including one at the harm or jeopardy level and three tied to abuse. The last inspection was July 18, 2024, and the for-profit partnership has drawn a 2/5 on health inspections with 1/5 on both quality measures and staffing.
Jefferson Health Care runs 118 beds in Lees Summit under corporate ownership, and the numbers describe a home stretched thin. Nurse staffing sits at 3.39 hours per resident day, roughly 12% under the national average, with weekends running about 16% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover is 64.2% against a national 45.8%, meaning most of the people caring for residents this year probably won't be there next year. The inspection record shows 61 deficiencies, including one at the harm level and three tied to abuse, plus $34,459 in fines. That inspection was recent, April 2025, so the picture isn't stale.
Magnolia Wellness Center runs 3.14 nurse hours per resident day, roughly 19% under the national average, and weekends drop another 16% below its own weekday coverage. That thin staffing shows in the numbers that matter: 63.6% annual turnover, 81 deficiencies on the current record, seven of them at harm or jeopardy level, and six tied to abuse. Four fines total $209,790, and the last inspection was February 2024. The four-star quality measure rating reflects resident assessments, not the hands available to act on them; the one-star inspection and staffing ratings come closer to daily reality. A for-profit individual owner with this record is worth asking hard questions about before you decide.
Hidden Lake runs on 2.52 nurse hours per resident day, roughly a third less than the national average of 3.86, and weekends drop another 4% below its own weekday level. The inspection record shows 83 deficiencies, seven of them serious enough to indicate harm or jeopardy, three tied to abuse, plus $123,610 in federal fines. CMS has placed it in the Special Focus Facility program, reserved for homes with a persistent pattern of poor care, and ownership changed within the past year. The last inspection was August 2024.
Nathan Richard Health Care Center runs on 1.72 nurse hours per resident per day, less than half the national average of 3.86, and weekend staffing dips slightly further. That thin coverage shows in the numbers: a 68.6% annual turnover rate, well above the 45.8% national figure, and a 1-out-of-5 CMS staffing rating. Its inspection record carries 38 deficiencies, including three at the harm or jeopardy level and two tied to abuse, plus a $69,107 fine. State inspectors last visited in February 2025. For-profit corporate ownership, 68 certified beds, and a two-star inspection and quality history round out the picture.
Grand Manor runs on about 2.00 nurse staffing hours per resident day, roughly half the national average of 3.86, and weekends drop another 20% below its own weekday level. That thin coverage shows up in the record: 46 deficiencies, including 2 at the harm or jeopardy level and 3 tied to abuse, plus a $99,988 fine. Inspectors were last on site September 13, 2024, and the federal ratings sit at 2 for health inspections, 2 for quality measures, and 1 for staffing. The for-profit limited liability company that owns it has kept the building certified, but the numbers describe a home where residents get substantially less nursing time than most places in the country.
Belleview Care Center runs 90 certified beds in Saint Joseph under for-profit corporate ownership, and the staffing numbers are where the trouble starts. At 3.40 nurse hours per resident day, it sits about 12% below the national average of 3.86, and weekends dip roughly 7% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Annual turnover of 59.8% against a national 45.8% means the aides and nurses your relative sees are cycling out faster than usual, which matters for anyone who needs consistent hands-on care. Add a two-out-of-five inspection rating, 53 deficiencies on the current record (two at harm level, six abuse-related), and $31,330 in fines across two actions, and the picture is a home that has struggled on multiple fronts at once.
Frequently asked questions
How many chain-owned nursing homes are there in Missouri?
There are 344 chain-owned Medicare-certified nursing homes in Missouri, 71% of the 487 nursing homes there.
Are chain-owned nursing homes better staffed?
In Missouri they average 3.3 total nursing hours per resident per day, against 3.43 for all nursing homes in Missouri, a difference of -0.13 hours. Staff turnover averages 57.3% against 56%.
Which chain-owned nursing home grades best in Missouri?